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Am J Physiol Renal Physiol (March 6, 2007). doi:10.1152/ajprenal.00521.2006
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Submitted on December 27, 2006
Accepted on February 25, 2007

LOSARTAN-HYDROCHLOROTHIAZIDE ASSOCIATION PROMOTES LASTING BLOOD PRESSURE NORMALIZATION AND COMPLETELY ARRESTS LONG TERM RENAL INJURY IN THE 5/6 ABLATION MODEL

Clarice Kazue Fujihara1, Denise Maria Avancini Costa Malheiros1, and Roberto Zatz1*

1 Renal Division, Department of Clinical Medicine, Faculty of Medical Science, University of São Paulo, São Paulo, SP, Brazil

* To whom correspondence should be addressed. E-mail: rzatz{at}usp.br.

The possible long-term renoprotective effects of treatment with thiazides, either as monotherapy or associated with renin-angiotensin suppressors, have not been assessed. We investigated the effect of hydrochlorothiazide (H), alone or combined with losartan (L), in the 5/6 renal ablation model (Nx). Adult male Munich-Wistar rats underwent Nx, remaining untreated for 1 month. At this time, functional and morphologic studies were performed in 21 rats (Group Nxpre). The remaining rats were distributed among Groups: Nx, no treatment, Nx+L, receiving L, 50 mg/Kg/day in the drinking water, Nx+H, receiving H, 6 mg/Kg/day in drinking water, and Nx+L+H, receiving both L and H as described. At 30 days of treatment, systemic and glomerular pressures were markedly elevated in Group Nx. Both H and L attenuated hypertension, whereas combined L+H treatment completely normalized both pressures. Eight months after Nx, mortality approached 70% in untreated rats, whereas severe albuminuria, hypertension, glomerulosclerosis and interstitial expansion were observed. H and L attenuated, but did not prevent, mortality, hypertension, and renal injury. Combined L+H treatment completely prevented mortality, normalized albuminuria and blood pressure, and arrested renal injury at levels found 1 month after ablation, despite the unusually long period of observation. Combined L+H treatment may represent an effective therapeutic alternative to prevent progression of chronic nephropathies.







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